Spinal Stenosis (Narrowing of the Spine)

Spinal stenosis is a condition where the spaces in the spine become too narrow, placing pressure on the spinal cord or the nerves that travel to the arms and legs. It most commonly affects the neck (cervical spine) and lower back (lumbar spine) and can lead to pain, numbness, or weakness that interferes with everyday activities. At The Orthopedic Partners, our spine team provides comprehensive care for spinal stenosis, from conservative treatments to advanced surgical options when needed.

What Is Spinal Stenosis?

Your spine forms a protective canal for the spinal cord and has small openings (foramina) where nerves exit to travel to the arms and legs. Spinal stenosis occurs when these spaces narrow. This can happen in the central canal (central stenosis) or in the foramina (foraminal stenosis).

Most cases develop gradually due to age-related changes in the discs, joints, and ligaments of the spine. Stenosis is most common in the lumbar and cervical regions, but it can occur at any level.

Symptoms of Spinal Stenosis

Symptoms vary based on where stenosis occurs and how much pressure is placed on nerves.

  • Neck or back pain that may be aching or sharp
  • Radiating pain into the arm (cervical) or leg (lumbar/sciatica)
  • Numbness or tingling in the hands, arms, legs, or feet
  • Weakness in the arms or legs
  • Balance or coordination problems, trouble with fine motor tasks (cervical)
  • Leg heaviness or cramping with walking that improves when bending forward or sitting (neurogenic claudication)

Seek emergency care right away for sudden, severe weakness, numbness in the groin/saddle area, or loss of bladder or bowel control.

What Causes Spinal Stenosis?

Common causes include:

  • Arthritis and bone spurs (osteophytes): Overgrowth of bone that encroaches on nerves
  • Degenerative disc disease: Loss of disc height and bulging that narrows space for nerves
  • Thickened ligaments: Stiffening or buckling of the ligamentum flavum into the canal
  • Herniated disc: Disc material pressing on the spinal cord or nerve roots
  • Spondylolisthesis: A slipped vertebra that narrows the canal or foramina
  • Spinal injuries or prior surgery: Fractures, dislocations, or scar tissue
  • Congenital narrowing or scoliosis: Naturally tight canals or curvature changing canal dimensions

Risk Factors

You may be more likely to develop spinal stenosis if you have:

  • Age over 50
  • Osteoarthritis or long-standing spine degeneration
  • History of spine injury or surgery
  • Genetic predisposition to a narrow canal or early degeneration
  • Physically demanding work or repetitive lifting/twisting
  • Sedentary lifestyle, poor posture, smoking, or excess body weight

How Is Spinal Stenosis Diagnosed?

We begin with a detailed history and physical exam to assess pain patterns, strength, sensation, reflexes, and walking tolerance. Imaging helps confirm the diagnosis and plan treatment:

  • X-rays: Visualization of alignment, disc height loss, bone spurs, or spondylolisthesis
  • MRI: Best view of nerves, discs, ligaments, and the degree of compression
  • CT or myelogram: Helpful when MRI is not possible or for complex anatomy
  • Electrodiagnostic testing (EMG/NCS): Useful in select cases to evaluate nerve function

Treatment Options for Spinal Stenosis

Treatment is personalized based on symptom severity, activity goals, and whether the spinal cord or nerves are being compressed.

Non-surgical Treatments

  • Activity modification and ergonomics to reduce symptom triggers
  • Physical therapy focused on posture, core and hip strength, flexibility, and a flexion-based program for lumbar stenosis
  • Medications such as anti-inflammatories or nerve-targeted agents
  • Epidural steroid injections to reduce inflammation around compressed nerves
  • Home exercise and weight management to support long-term relief

Surgical Treatment

Surgery may be recommended for persistent pain, limited walking tolerance, progressive weakness, or when non-surgical care hasn’t provided relief. For lumbar spinal stenosis, options include:

  • Lumbar Decompression: Removes bone spurs, overgrown ligaments, and any herniated disc material compressing the spinal nerves
  • Lumbar Decompression and Fusion: Removes bone spurs, overgrown ligaments, and any herniated disc material compressing the spinal nerves and stabilizes the spine through an incision on the low back.
  • Minimally Invasive TLIF (MIS TLIF): A less invasive method to decompress the spinal nerves and stabilize the spine with quicker recovery.
  • Lateral Lumbar Interbody Fusion (LLIF): A minimally invasive approach from the side to relieve nerve compression and stabilize the spine.
  • Anterior Lumbar Interbody Fusion (ALIF): Fusion performed through the abdomen to treat disc degeneration, spinal deformity, or spondylolisthesis contributing to stenosis.
  • Lumbar Facet Joint Replacement (Lumbar Facet Arthroplasty): An alternative to fusion for relief of spinal stenosis and stabilization of slipped vertebrae while preserving motion.

Whenever appropriate, we use robotic-assisted and computer-navigated techniques to enhance precision, optimize implant placement when fusion is needed, and support safer outcomes.

When to See a Spine Specialist

Schedule a visit if you have ongoing neck or back pain with radiating symptoms, leg heaviness with walking, or balance and coordination problems. Do not wait if your symptoms are worsening, or if you notice weakness or changes in bladder or bowel function.

Expert Care for Spinal Stenosis

At The Orthopedic Partners, we help patients with spinal stenosis find relief and stay active. From targeted therapy and injections to minimally invasive and complex reconstruction, we will tailor a plan to your goals and lifestyle.

Schedule your evaluation today and take the next step toward lasting relief.